Can Tumors Reoccur After Complete Breast Removal?

Will the cancer recur after the entire breast has been removed?

Hello, doctor.
I had surgery in May this year for in situ carcinoma, and my entire breast was removed.
I'm not sure if it's due to the hot weather causing eczema or something else, but I've developed an itchy area along the long scar, and I've noticed a small bump (about 0.1 cm) on it.
I haven't used silicone gel for several weeks because I thought the wound could handle water, so I've been lazy about applying it.
I would like to ask if, since the entire breast was removed, there is still a possibility of a tumor developing on the scar? Thank you! I appreciate your hard work!

Haihua, 40~49 year old female. Ask Date: 2017/08/22

Dr. Chen Jiaming reply Surgery

In general, in situ carcinoma lesions are confined to the breast tissue.
During a total mastectomy, the procedure typically involves cutting along the peripheral tissues, rarely directly contacting the tumor tissue, which results in a low incidence of residual cell recurrence.
However, there have been case reports indicating that the slicing process may allow some cells to leave their original location (for example, along the slicing path).
Therefore, there are still cases of total mastectomy where this issue has arisen.
It is recommended to return to the original treatment facility for evaluation by a breast surgeon or to arrange for a local excision.

Reply Date: 2017/08/22

More Info

After a complete breast removal, also known as a mastectomy, the risk of tumor recurrence is generally low, especially if the surgery was performed for ductal carcinoma in situ (DCIS) or invasive breast cancer with clear margins. However, it is important to understand that while the likelihood of recurrence in the same breast is significantly reduced, it is not entirely eliminated.
In your case, since you had a mastectomy due to DCIS, the primary tumor was removed, and the surrounding tissue was also excised to ensure that no cancerous cells were left behind. The presence of a small bump or granulation tissue at the surgical site does not necessarily indicate a recurrence of cancer. It could be a benign condition, such as scar tissue or a small cyst, especially if it is not hard or fixed to the underlying tissue. However, any new growth or change in the surgical area should be evaluated by your healthcare provider to rule out any potential issues.

Regarding the concern about the small bump you felt on the scar, it is not uncommon for patients to experience changes in the skin and tissue after surgery. These changes can include itching, redness, and the formation of small nodules or bumps as part of the healing process. If the bump is soft, movable, and not associated with any other symptoms (such as pain or discharge), it is likely benign. However, if it persists, grows, or is accompanied by other concerning symptoms, it is advisable to consult your surgeon or oncologist for further evaluation.

In terms of recurrence, it is essential to consider that breast cancer can recur in the remaining breast tissue or even in other parts of the body, depending on the individual’s risk factors, such as hormone receptor status, age, and overall health. Regular follow-up appointments and screenings are crucial for early detection of any potential recurrence.
For patients who have undergone a mastectomy, additional treatments such as radiation therapy, hormone therapy, or chemotherapy may be recommended based on the specific characteristics of the cancer and the patient's overall treatment plan. These therapies can further reduce the risk of recurrence by targeting any remaining cancer cells that may not have been removed during surgery.

In summary, while the risk of tumor recurrence after a complete breast removal is low, it is not zero. It is vital to maintain regular follow-ups with your healthcare provider, report any new symptoms, and adhere to any recommended adjuvant therapies to minimize the risk of recurrence. If you have concerns about the bump on your scar or any other symptoms, do not hesitate to reach out to your medical team for guidance and reassurance.

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